Clear aligner therapy and its effectiveness in the management of overbite and inter-arch occlusal contact: A narrative review

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2025

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Lim, Z.W.
Meade, M.J.

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Seminars in Orthodontics, 2025; 1-21

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Zi Wei Lim, Maurice J. Meade

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Background and aim: Managing overbite and occlusal contacts are key objectives of orthodontic treatment. This article aims to highlight the current literature on clear aligner therapy’s (CAT) effectiveness in achieving these objectives. Methods: A search of the literature involving only studies of original research was carried out. Only articles from peer-reviewed journals were included. Citation searching was also used to attempt to capture further relevant studies. Results: Forty-nine studies were included in this narrative review. Most studies fulfilling inclusion criteria were retrospective and involved the use of the Invisalign® appliance. For deep bite cases treated with CAT, the actual overbite achieved was significantly less than planned, whereas for mild open bite cases, there appeared to be little difference between the planned and achieved overbite. Studies on the componentry of overbite correction using CAT have shown that actual outcomes for anterior intrusion, posterior extrusion, and transverse expansion are less effective than planned. There appeared to be a decrease in the number and magnitude of occlusal contacts, especially posteriorly, following wear of the appliance. Clinical Practice: This narrative review lists several methods suggested by the included studies to overcome the issues involving deep bite correction. Research recommendations: Future research may wish to adopt a prospective approach to establish causal relationships. A standardised method of reporting on CAT protocol may also aid in accounting for possible unknown variables and allow better comparisons between studies. Subgroup analyses of the effects of auxiliaries and overcorrection within studies would also help inform clinical practice.

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© 2025 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)

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